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Is cholesterol good or bad ?

Cholesterol is a molecule of fat which your body uses to make hormones and cell membranes. Despite its bad reputation, cholesterol is essential to the function of your body, and unnecessarily lowering cholesterol below optimal levels can cause detrimental effects on your body.

When deposits of cholesterol form unwanted build-ups inside your artery walls, however, they can become inflamed attracting the attention of other cells, including cells from your immune system. These microscopic clumps may break off, triggering clots that block blood flow, causing heart attacks and strokes.

To explain more about why the “bad” cholesterol”, or low density lipoprotein (LDL) was singled out, we need to look at the Framingham study; this was a government study conducted in Framingham, Massachusetts USA involving over 5,000 people who consented to be tracked throughout their whole lives in order to solve the riddle of what causes heart attacks. And in 1961, the Framingham study indicated that cholesterol may be a factor. The Framingham study singled out LDL or “low-density lipoprotein” as the villain and, in 1977, concluded that LDL (which quickly came to be known as “bad cholesterol”) was a risk factor. But – it was never proved that LDL was the actual cause of heart disease, but that it was implicated in some sense.

When I did a post graduate course in Seattle in 2003, Dr. Alan Gaby, one of America’s leading doctors said that “cholesterol is no more indicated as a leading cause of heart disease anymore than a fire truck is the cause of a fire”. Whilst it is true that you generally see fire trucks around fires, you can’t really say that they actually caused the fire; you can only see that there is a correlation between them both”. The same goes for high cholesterol, you may see an elevation of LDL with heart disease in some (approx. 50%) but not all people with heart disease. Nobody can categorically state that “LDL (the bad cholesterol) causes heart disease”. Despite popular notions to the contrary, there is absolutely no rock-solid scientific evidence that lowering cholesterol has any benefit towards preventing atherosclerosis (your arteries clogging up). In fact, with so many studies, too numerous to mention – almost the opposite appears to be true.

Is a high fat diet primarily the cause of your arteries to clog up leading to heart disease? – not really. It is the type of fats we eat, and the fact that we eat the wrong carbs too. Is cholesterol the bad guy that needs lowering at all costs? Not really, according to many leading experts in this field.

Should you take a drug to lower your cholesterol, because you were told that it would prevent heart disease? This may come as a surprise to you – the answer is again no, not really. The question of cholesterol lowering drugs (Statin drugs) yes or no is an important one because of the sheer numbers of people in NZ who take these drugs is in the many hundreds of thousands.

You have a right to be very skeptical, particularly when it concerns your health. I do believe that there is a (tiny) place for these powerful drugs, but I also believe they are over-prescribed at the drop of a hat, just like antibiotics used to be, and still are by some.